Jury Links Man's Death to Bed Shortage

The coroner's report into the death of a Vancouver Island man could re-ignite a fierce debate over hospital bed closures when it is released next month, just 10 days before the provincial election.

The jury investigating the death of Gordon Parker recommended to the Vancouver Island Health authority that more beds be opened at the West Coast General Hospital in Port Alberni. Nine of the hospital's 39 beds were closed by the authority in 2003 to make up for a budget shortfall.

That recommendation, along with several others, was included in the jury's verdict released on April 7. But it's the coroner's report, to be issued May 7, that could prove politically explosive.

Hospital 'needs more beds'

Parker was treated at West Coast General on June 5, 2004 for a potentially lethal level of alcohol in his blood before being released to the RCMP where he was booked for public drunkenness and tossed in jail.

Given that the Coroner's verdict recommended that "West Coast General Hospital needs more beds" the report could show that Parker should have been kept in hospital for observation and that he was released, at least in part, because of a bed shortage.

Neither the health authority nor the ministry of health would comment on the case before the full report is issued. And no one at the hospital would say whether Parker was released because of a lack of beds.

But the bed closures have meant that doctors aren't always keeping patients as long as they'd like, according to Dr. Curt Smecher, West Coast General's Chief of Staff.

"The problem is not in the black and white cases. Patients aren't being sent home when it's clear they need treatment," he said. "Where we run into problems is the grey area where you'd like to keep someone for treatment, but you aren't sure… Not having beds available does affect your judgment" on whether to admit non-critical cases.

'Stretchers in hallways'

West Coast General opened in September 2001. Two years later, over massive local protest, the Vancouver Island Health Authority announced they were closing 19 critical care beds at the facility, nine of them permanently.

In the immediate aftermath of the closures, patients were cramped together in hallways and ambulatory units, according to Jack McLeman, a member of the Save Our Services coalition, a local group lobbying for the beds to be restored.

"Patients were put in stretchers in hallways near people with open wounds and barfing and all that," McLeman said.

Then Minister of Health Colin Hansen defended the bed closures at the time, blaming them on "construction deficiencies" in the hospital, which was built under the previous NDP government. He called it "a big mistake" to measure "access to health care by counting the number of beds" because many procedures require less patient time in hospital than previously.

As the big city media, including the Victoria Times Colonist and the Vancouver Sun picked up the story, the closures became a public relations disaster for the government.

Ten of the 19 beds were reopened, but the staff levels remained the same.

First hour after stroke crucial

Since then the hospital has been constantly overcrowded and understaffed according to Dr. Smecher. With nurses and doctors working too many hours, and seeing too many patients, Smecher said that only "time, luck and professionalism" are keeping serious accidents from occurring. Whether or not a serious accident occurred in Parker's case is difficult to tell because even if doctors had kept him under observation, there's no guarantee he would have survived the stroke, according to Dr. Dan Straathof, the forensic pathologist who performed Parker's autopsy.

But according to one heart and stroke expert who spoke to The Tyee, the odds of recovering from stroke increase dramatically with prompt treatment. The chances of having complete recovery are good in the first hour, then drop off quickly, so that by four to eight hours there may be no benefit at all.

What makes things tricky in Parker's case is that the symptoms of stroke could be mistaken for those of a drunken stupor, according to Straathof.

A stroke happens when a blood vessel bursts in the brain. The severity of the stroke is measured by how big the burst, or hemorrhage, is. Parker's stroke was severe enough to eventually be fatal, but in the immediate aftermath of the incident, Parker's symptoms, like loss of speech and balance, might not have looked that different from the ones people had come to expect from a chronic drunk.

Paramedics left man in jail

Parker was conscious when the hospital released him to police, according to Staff Sergeant Lee Omilusik of the Port Alberni RCMP, but his blood alcohol level was still off the charts. So when he fell and struck his head later that night, paramedics decided not to take him back to hospital.

When he eventually did end up back at the West Coast General, after falling again a couple of hours later, doctors discovered that he wasn't just drunk, he had suffered a stroke. He was then airlifted to Victoria and pronounced dead the next morning.

Whether or not Parker could have been saved by staying in hospital, and whether the decision to release him was based on a lack of beds won't be known until the coroner's report is released next month. And until then, no one, from the health authority to the Ministry to the coroner herself is talking.

But though Smecher wouldn't comment on Parker's case specifically he had no qualms about airing his opinion on the effect of the bed closures.

"We're continually over census," he said. "I don't think the previous government built a hospital with too many beds."

Richard Warnica is on staff at The Tyee.